| NPI | 1619134277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMI ECHI-ABOLI Billing Department Director 208-360-1038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2025-02-19 |